T Jegathesan, Stewart Camilla J, Tong Pei Y, Lam Wee L, Rajaratnam Vaikunthan
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Novena, Singapore.
Department of Plastic Surgery, Chelsea and Westminster Hospital, United Kingdom.
J Hand Microsurg. 2020 Sep 9;14(4):284-291. doi: 10.1055/s-0040-1715927. eCollection 2022 Oct.
Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations. Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren-Lawrence (K-L) score. Chi-square test, Fisher's exact test, or Student's -test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints. A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant ( = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population. Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.
此前已有多项研究对高加索人、日本人、中国人和阿拉伯人群中手部放射学骨关节炎（OA）的患病率进行了调查。迄今为止，尚未有关于西方人群和东南亚人群之间手部放射学OA患病率的直接国际比较研究。我们假设这两个人群个体的关节受累模式存在差异。
对60岁及以上个体的连续手部X光片进行了回顾。使用Kellgren-Lawrence（K-L）评分对手部各关节的骨关节炎放射学证据进行分级。根据情况使用卡方检验、Fisher精确检验或学生t检验。进行多因素逻辑回归分析以评估手部放射学OA在各关节之间的关联和关系。
共有194例患者表现出放射学OA。与拇指腕掌关节（CMCJ；40.2%）相比，新加坡患者更易出现拇指指间关节（IPJ）的放射学OA（65.1%）；英国患者出现CMCJ的OA（43.3%）比拇指IPJ的OA（21.0%）更常见。差异具有统计学意义（P = 0.00026）。在新加坡人群中，患者更有可能同时患有拇指和手指关节的OA，而在英国人群中，仅在80岁以上组中明显。新加坡人群中最常受累的关节是左手拇指IPJ（关节特异性患病率为35%），英国人群中是右手示指远侧指间关节（DIPJ；关节特异性患病率为41.5%）。
我们的研究是第一项比较新加坡人和英国人的研究，显示手部OA患病率存在统计学显著差异。这些发现表明种族和文化因素在这种分布趋势中起作用。
